controlling protein spikes

I've yet to put tackling protein spikes into practice so I'll be interested to hear what others say.

What I have decided is that I should give a go at trying a dual bolus dose when having highly protein based meals. I've yet to try it so can't whether this approach will be safe.

For say a steak with only a little carbohydrate in vegetables, I'd usually inject around 5 units at the start of the meal and then go a bit low after 2 hours and then get hit with a high 3 or 4 hours later.

So I'm thinking to take things gently and try injecting say 3 units at first and then 2 units 2 hours after the start of the meal.

I'd expect myself to trend a bit high but wouldn't want to increase the total dose for the meal until I know it's not going to send me too low.

If you decide to try something new, make sure you keep your numbers on the safe side and don't risk going too low.

All the best
Ed

victoria84 said:

yes going too low is the last thing i want, hopefully someone will come along with a good solution

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If your sticking to low-carb in the long-term it may be worth your while asking about changing to a slower acting insulin to take with your meals, Novorapid and Apidra work quite fast and I struggled to get decent control after eating protein based meals when experimenting with low carbs.

Good luck and hope you find a solution!

Hi Victoria,
I'm a T1 LCer. I've managed to get to grips with the protein spike. I've noticed that if I have some protein with my lunch, my postprandial level will be consistent with my pre-lunch levels, but then my pre-dinner level will be 2 mmol/l higher than my lunch postprandial. As it happens, that's 1u of Novorapid for me, so that's that sorted.

First, as obvious as it seems, try to reduce your protein portion size. I tend to stick to the same portion size as before I LC'd. I once had a mixed grill, post meal levels were perfect, but then a few hours later I was at 12. So I tend to avoid eating too much meat.

Insofar as Novorapid dosing is concerned, I give myself my normal mealtime dose, then 2 hours later I'll dose for the protein. I go by the rule I use for lunch where 1 unit works fine for 1 chicken breast sized portion of meat.

What would be useful is if you could post your numbers. In particular, your pre- and post-meal readings then your spike reading and how long after the meal that reading was at. This is so we can match the Novorapid peak with your spike, which happens 1.5 to 2 hours after injection.

Just as an addendum to what I've said. Last night I ordered a large mixed kebab (I didn't eat the pitta, just the meat and the salad) and there was a LOADS of meat there - a large plastic takeaway tray full. Here are my readings:

pre-meal: 6.1 (took my usual 6u Novorapid)
post-meal: 7.7 (then took 2u Novorapid for the protein)
One hours after protein bolus: 6.3
Two hours after protein bolus: 5.9
Pre-breakfast (next day): 6.1